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Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

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Inhaltsverzeichnis / Table of Contents 吸入物/目录
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-04-16 DOI: 10.1016/S1865-9217(25)00105-9
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引用次数: 0
Plädoyer für ein nachhaltigeres Gesundheitssystem – die Rolle der Technologiebewertung [为更可持续的卫生保健系统辩护——技术评估的作用]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-26 DOI: 10.1016/j.zefq.2025.03.003
Matthias Perleth , Barbara Buchberger , Peter Kolominsky-Rabas
Health Technology Assessment (HTA) is established as a tool for evidence-based decision support in the health care sector. HTA aims to determine the value of a health technology at different points in its life cycle and to promote an equitable, efficient and high-quality health care system.
The health care sector is estimated to be responsible for 5% of greenhouse gas emissions and raw material consumption. Buildings, anesthetic gases, metered dose inhalers, pharmaceuticals and medical devices are important drivers of these emissions.
So far, sustainability as (according to Brundtland) a development that meets the needs of the present without compromising the ability of future generations to meet their own needs, has not played a role as a decision-making criterion in the introduction and provision of health care technologies. The concept of sustainability could extend HTA to the entire life cycle (the ‘first’ and the ‘last’ mile) and thus establish the ecological footprint as a further dimension in the assessment process. Despite international efforts to achieve climate neutrality in the health care sector, there are as yet no concrete strategies for implementation in Germany and Europe, with the exception of the UK. The political mood is even moving in the direction of climate policy regression.
A sustainability strategy could draw on a large number of national and European regulations outside the health care sector and integrate them into existing methodological approaches, such as the incremental carbon footprint effectiveness ratio. At the practical level, these findings could be incorporated into climate-sensitive health counseling. The future federal government, professional associations and health care professionals should take urgent action.
卫生技术评估(HTA)是作为卫生保健部门基于证据的决策支持工具而建立的。卫生技术评价旨在确定一项卫生技术在其生命周期不同阶段的价值,并促进建立一个公平、高效和高质量的卫生保健系统。据估计,卫生保健部门占温室气体排放和原材料消耗的5%。建筑物、麻醉气体、计量吸入器、药品和医疗设备是这些排放的重要驱动因素。迄今为止,可持续性(根据布伦特兰的说法)是一种满足当代人的需要而不损害后代人满足其自身需要的能力的发展,在引进和提供保健技术方面尚未作为一项决策标准发挥作用。可持续发展的概念可以将HTA扩展到整个生命周期(“第一英里”和“最后一英里”),从而将生态足迹作为评估过程中的进一步维度。尽管国际社会努力在卫生保健领域实现气候中和,但在德国和欧洲,除英国外,还没有具体的实施战略。政治情绪甚至正朝着气候政策倒退的方向发展。可持续性战略可借鉴医疗保健部门以外的大量国家和欧洲法规,并将其纳入现有的方法学方法,如增量碳足迹效率比。在实际层面上,这些发现可以纳入对气候敏感的健康咨询。未来的联邦政府、专业协会和卫生保健专业人员应该采取紧急行动。
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引用次数: 0
Physiotherapeutische Forschungsaktivitäten an den deutschen Universitätskliniken: eine Online-Umfrage unter den Leitungen der physiotherapeutischen Abteilungen [德国大学医院的物理治疗研究活动:对物理治疗部门负责人的在线调查]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-19 DOI: 10.1016/j.zefq.2025.02.006
Erik J. Ehlers , Franziska Feldmann , Judith Gartmann , Carolin Kraushaar , Annalena Paus , Isabelle Stickdorn , Susanne G.R. Klotz

Introduction

German university hospitals, with their three pillars of research, teaching, and care, enjoy a special status in the health care and science system. Alongside care and teaching, the research pillar has also become increasingly relevant for physiotherapy at university hospitals. Nevertheless, there has been no comprehensive study to date of the status of physiotherapy research activities at German university hospitals. This study aims to provide an overview of research activities and their framework conditions.

Methods

A cross-sectional online survey was conducted among the heads of physiotherapy departments at all 36 German university hospitals in order to collect data on physiotherapy research activities. The questionnaire used for this purpose was developed in advance with the help of a systematic literature review and an expert survey. The survey was analyzed descriptively.

Results

With a response rate of 58%, eight of the 21 university hospitals included in the survey have been conducting physiotherapy research, in some cases for over a decade. The most frequently reported obstacles to research are lack of financial resources (n = 10) and lack of interest or appreciation from other professions (n = 7). Most frequently, research projects are conducted in the medical specialties of orthopedics and trauma surgery (n = 10), intensive care medicine (n = 8), pediatrics (n = 6), and the outpatient sector (n = 6). Clinical research accounts for 58% (n = 18) of research activities. Interprofessional research is more common (n = 13, 72%) than intraprofessional research (n = 5, 28%). In addition to the CRediT roles of resources (n = 6) and investigation (n = 6), the role of conceptualization in the research process (n = 6) is also among the most common. Over the two-year period, a median of three articles was published with first or last authorship assigned to physiotherapists.

Conclusion

The online survey shows that there is little physiotherapy research activity at German university hospitals. In order to strengthen physiotherapy research, changes in professional and scientific policy and financial support are needed.
德国大学医院以科研、教学、护理为三大支柱,在卫生保健和科学体系中享有特殊地位。除了护理和教学之外,研究支柱也与大学医院的物理治疗越来越相关。然而,迄今为止尚未对德国大学医院的物理治疗研究活动状况进行全面研究。本研究旨在概述研究活动及其框架条件。方法:对德国所有36所大学附属医院的物理治疗部门负责人进行横断面在线调查,以收集有关物理治疗研究活动的数据。用于此目的的问卷是在系统的文献回顾和专家调查的帮助下事先制定的。对调查进行了描述性分析。结果:参与调查的21家大学医院中,有8家一直在进行物理治疗研究,有的已经进行了10多年,回复率为58%。最常见的研究障碍是缺乏财政资源( = 10)和缺乏其他专业的兴趣或赞赏( = 7)。最常见的研究项目是在骨科和创伤外科( = 10)、重症监护医学( = 8)、儿科( = 6)和门诊部( = 6)等医学专业进行的。临床研究占研究活动的58% (n = 18)。跨专业研究(n = 13,72%)比专业内研究(n = 5,28%)更为常见。除了资源(n = 6)和调查(n = 6)的信用作用外,概念化在研究过程中的作用(n = 6)也是最常见的。在这两年期间,发表的第一或最后作者为物理治疗师的文章中位数为三篇。结论:在线调查显示,德国大学医院的物理治疗研究活动很少。加强物理治疗研究,需要改变专业、科学的政策和资金支持。
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引用次数: 0
Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations 附属机构名单
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-18 DOI: 10.1016/S1865-9217(25)00077-7
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引用次数: 0
Inhaltsverzeichnis / Table of Contents 吸入物/目录
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-18 DOI: 10.1016/S1865-9217(25)00073-X
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引用次数: 0
Herausgeberkollegium / Editorial Board Herausgeberkollegium编委会
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-18 DOI: 10.1016/S1865-9217(25)00072-8
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引用次数: 0
Organisationale Maßnahmen zur Stärkung der Arbeitszufriedenheit in der stationären Langzeitpflege: eine Querschnittstudie aus Österreich [提高住院长期护理工作满意度的组织措施:来自奥地利的横断面调查]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-11 DOI: 10.1016/j.zefq.2025.01.001
Alexander Braun , Markus Latzke , Manfred Pferzinger , Adelheid Schönthaler

Background

With increasing care needs and a decline in nursing staff, measures must be found to make long-term care (LTC) attractive for nursing staff and at the same time encourage them to remain in the care sector. For this reason, the question is answered: “How do organizational measures, identified by nursing staff, contribute to improving job satisfaction?”.

Method

In a non-proportional quota sample along the federal state distribution, the implementation of measures was surveyed in a cross-sectional survey in LTC facilities. The effect of the measures on job satisfaction was analyzed using multiple linear regression.

Results

The bundles of measures show a high internal consistency of 0.771 to 0.863. Regression analyses revealed that the bundles of measures, like making LTC more attractive (B = 0.244; p < 0.05), integrating interns (B = 0.222, p < 0.05), duty scheduling and working hours (B = 0.324, p < 0.05), and strengthening relationships (B = 0.078), explain more than 60% of the variance in job satisfaction. Overtime has a negative effect but can be mitigated by duty scheduling (B = –0.017, p < 0.05). Women report higher levels of job satisfaction than men. The type of organization, age and vocational training have no influence on job satisfaction.

Discussion

Duty scheduling and working hours are important factors. Loss in job satisfaction can be cushioned by focusing on these measures.

Conclusions

The bundles of measures “Making LTC more attractive”, “Duty scheduling and working hours”, “Integrating interns”, and “Strengthening relationships” are positively associated with job satisfaction. Accordingly, care facilities that implement these bundles of measures have higher job satisfaction rates.
背景:随着护理需求的增加和护理人员的减少,必须找到措施,使长期护理(LTC)对护理人员有吸引力,同时鼓励他们留在护理部门。因此,这个问题的答案是:“由护理人员确定的组织措施如何有助于提高工作满意度?”方法:在沿联邦州分布的非比例配额样本中,对LTC设施的实施情况进行了横断面调查。运用多元线性回归分析了这些措施对工作满意度的影响。结果:测量束具有较高的内部一致性(0.771 ~ 0.863)。回归分析显示,一系列措施,如使LTC更具吸引力(B = 0.244;p 讨论:任务安排和工作时间是重要的因素。通过关注这些措施,可以缓解工作满意度的下降。结论:“让LTC更有吸引力”、“值班安排和工作时间”、“整合实习生”和“加强关系”措施束与工作满意度呈正相关。因此,实施这些措施的护理机构具有更高的工作满意度。
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引用次数: 0
Abschlusseditorial Abschlusseditorial .
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-11 DOI: 10.1016/j.zefq.2025.02.005
Susanne Knappe , Ute Lewitzka , Anna Kuehne , Arne Bürger
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引用次数: 0
Fatigue bei Krebs: Wie (gut) sind Betroffene an onkologischen Einrichtungen in Deutschland versorgt? 癌症相关疲劳:德国癌症护理机构的护理质量如何(好)?]
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-08 DOI: 10.1016/j.zefq.2025.02.003
Anna S. Wagner , Marlena Milzer , Senta Kiermeier , Martina E. Schmidt , Truong D. Nguyen , Karen Steindorf , Imad Maatouk

Background

One of the most common sequelae of cancer and/or its treatment is cancer-related fatigue (CRF). For those affected, CRF is often accompanied by considerable, even long-term impairment. This makes it all the more important to examine how care is provided in Germany and to what extent guideline recommendations are implemented in clinical practice.

Methods

In a Germany-wide questionnaire survey, inpatient and outpatient oncological cancer care facilities were asked to describe their approach to CRF (information and education, screening, diagnostics), local treatment options, and clinical trials.

Results

A total of 145 facilities participated, including 11 comprehensive cancer centers, 35 organ-specific cancer centers, 22 hospitals with a (hemato-)oncology unit, 29 outpatient (hemato-)oncology practices, 48 outpatient cancer counseling units. Nearly all the facilities reported that patients are provided verbal health information (per groups: 90.9%, 88.6%, 90.9%, 96.9%, 72.9%); less frequently in written form (90.9%, 54.3%, 59.1%, 48.3%, 87.5%). A systematic screening for CRF is conducted in up to one-third of the facilities (per groups: 27.3%, 20.0%, 31.8%, 17.2%, 8.3%). A standardized procedure for further clarification of CRF is available at a small number of institutions (0%, 11.4%, 13.6%, 6.9%, 2.1%). Exercise (90.9%, 82.9%, 72.7%, 79.3%, 89.6%) and psychotherapeutic services (90.9%, 68.6%, 86.4%, 62.1%, 68.8%) are most frequently actively recommended to patients with CRF across the facility groups.

Discussion

With regard to the systematization of screening and diagnosis of CRF as well as the provision of information material, there is a clear discrepancy between guideline recommendations and everyday clinical practice.
背景:癌症和/或其治疗最常见的后遗症之一是癌症相关性疲劳(CRF)。对于那些受影响的人来说,慢性肾功能衰竭往往伴随着相当大的,甚至是长期的损害。这使得检查在德国如何提供护理以及指南建议在临床实践中的实施程度变得更加重要。方法:在德国范围内的问卷调查中,要求住院和门诊肿瘤护理机构描述他们的CRF方法(信息和教育,筛查,诊断),当地治疗方案和临床试验。结果:共有145家机构参与,包括11家综合性癌症中心、35家器官特异性癌症中心、22家设有(血液)肿瘤科室的医院、29家门诊(血液)肿瘤诊所、48家门诊癌症咨询单位。几乎所有机构都报告向患者提供口头健康信息(每组:90.9%、88.6%、90.9%、96.9%、72.9%);书面表达频率较低(90.9%、54.3%、59.1%、48.3%、87.5%)。在多达三分之一的设施中对CRF进行了系统筛查(每组:27.3%,20.0%,31.8%,17.2%,8.3%)。少数机构有进一步澄清CRF的标准化程序(0%、11.4%、13.6%、6.9%、2.1%)。运动(90.9%,82.9%,72.7%,79.3%,89.6%)和心理治疗服务(90.9%,68.6%,86.4%,62.1%,68.8%)在各机构组中最常被积极推荐给CRF患者。讨论:关于CRF筛查和诊断的系统化以及信息材料的提供,指南建议与日常临床实践之间存在明显差异。
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引用次数: 0
Voraussetzungen und Lösungsansätze für eine praxisrelevante Pflegeforschung in der Akutversorgung in Deutschland: Ergebnisse eines Scoping-Workshops [德国急症护理实践相关护理研究的要求和可能的解决方案:范围界定研讨会的结果]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-03-04 DOI: 10.1016/j.zefq.2025.02.004
Martin Müller , Sascha Köpke , Gabriele Meyer
Nursing science as an academic discipline in Germany is still developing and has not yet been sufficiently integrated into acute hospital care. The aim of this paper is to analyze the key challenges of nursing research in acute hospital care and to develop strategic solutions to strengthen the development of nursing science in Germany. The results of a two-day scoping workshop with national and international experts indicate that the lack of structural integration of nursing science into clinical care, the low number of academically qualified nursing professionals, and insufficient research funding are major obstacles to further development. Based on a SWOT analysis, six priority action areas were identified: (1) development and implementation of qualification and career programs, (2) promotion of clinician scientists, (3) strengthening visibility and communication, (4) effective political participation, (5) increase of research funding, and (6) improvement of networks and collaborations. The implementation of these strategies will contribute to establishing nursing science as an independent discipline, increasing its societal relevance, and promoting evidence-based nursing practice in inpatient acute care. Close collaboration among academia, policymakers, and practitioners is essential for achieving these goal.
护理科学作为一门学术学科在德国仍处于发展阶段,尚未充分融入急性医院护理。本文的目的是分析急诊护理研究面临的主要挑战,并制定战略解决方案,以加强德国护理科学的发展。由国内和国际专家参加的为期两天的范围界定研讨会的结果表明,护理科学缺乏与临床护理的结构性整合,学术上合格的护理专业人员数量少,研究经费不足是进一步发展的主要障碍。基于SWOT分析,确定了六个优先行动领域:(1)制定和实施资格和职业计划,(2)促进临床科学家,(3)加强知名度和沟通,(4)有效的政治参与,(5)增加研究经费,(6)改善网络和合作。这些策略的实施将有助于建立护理科学作为一门独立的学科,增加其社会相关性,并促进住院急症护理的循证护理实践。学术界、政策制定者和实践者之间的密切合作对于实现这些目标至关重要。
{"title":"Voraussetzungen und Lösungsansätze für eine praxisrelevante Pflegeforschung in der Akutversorgung in Deutschland: Ergebnisse eines Scoping-Workshops","authors":"Martin Müller ,&nbsp;Sascha Köpke ,&nbsp;Gabriele Meyer","doi":"10.1016/j.zefq.2025.02.004","DOIUrl":"10.1016/j.zefq.2025.02.004","url":null,"abstract":"<div><div>Nursing science as an academic discipline in Germany is still developing and has not yet been sufficiently integrated into acute hospital care. The aim of this paper is to analyze the key challenges of nursing research in acute hospital care and to develop strategic solutions to strengthen the development of nursing science in Germany. The results of a two-day scoping workshop with national and international experts indicate that the lack of structural integration of nursing science into clinical care, the low number of academically qualified nursing professionals, and insufficient research funding are major obstacles to further development. Based on a SWOT analysis, six priority action areas were identified: (1) development and implementation of qualification and career programs, (2) promotion of clinician scientists, (3) strengthening visibility and communication, (4) effective political participation, (5) increase of research funding, and (6) improvement of networks and collaborations. The implementation of these strategies will contribute to establishing nursing science as an independent discipline, increasing its societal relevance, and promoting evidence-based nursing practice in inpatient acute care. Close collaboration among academia, policymakers, and practitioners is essential for achieving these goal.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"193 ","pages":"Pages 104-111"},"PeriodicalIF":1.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen
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